Provider Demographics
NPI:1366690356
Name:BRITTAIN, NANCY ANN (MSOM, LAC)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:ANN
Last Name:BRITTAIN
Suffix:
Gender:F
Credentials:MSOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 N 88TH ST
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4613
Mailing Address - Country:US
Mailing Address - Phone:414-774-9058
Mailing Address - Fax:
Practice Address - Street 1:161 N 88TH ST
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-4613
Practice Address - Country:US
Practice Address - Phone:414-774-9058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI376 055171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist